An efficacious treatment is diminished in value if clients will not seek it out and adhere to it (Kazdin, 1978). Thus, the acceptability of a treatment to consumers is an important indicator of the quality/effectiveness of the treatment (APA, 2002). The purpose of this study was to examine acceptability of treatments for depression to adolescent females and to explore factors that might be associated with acceptability. Sixty-seven high school students (36 Hispanic and 31 non-Hispanic White) were recruited from communities in New Jersey and Florida, and interviewed by telephone. Participants were presented with a vignette describing a depressed adolescent and asked to use the Abbreviated Acceptability Rating Profile to indicate their opinion of four single treatments (cognitive-behavioral therapy, interpersonal therapy, family therapy, and pharmacotherapy) for depression and three treatment combinations. Consistent with hypotheses, psychotherapy approaches were generally more acceptable to adolescents than combinations of psychotherapy and pharmacotherapy. Pharmacotherapy used alone was not acceptable, on average. There was preliminary evidence to support the hypotheses that treatment acceptability is related to ethnicity, acculturation, and perceived causes of depression; however, contrary to expectations, treatment acceptability was not associated with symptom severity in this study. Implications for increasing the utilization of mental health services in this population are discussed and directions for future research are offered.

No description available.

Malaria is more prevalent today and the death toll is on the increase annually. It is one of the leading causes of morbidity and mortality worldwide and most of these deaths are in the poorest regions of the world. About 500 million cases are reported annually with more than 2 million deaths, and most are children. It is the major killer in the tropics and a major public health problem in developing countries and Papua New Guinea (PNG) is no exception. Resistant strains have been reported. This may be enhanced by inappropriate human behaviour in the use of anti-malarial drugs. Human factors include inappropriate prescribing and patient behaviour in using anti-malarial drugs. Despite the establishment of the standard treatment guidelines for malaria in PNG, three out of every four patients have chloroquine-resistant falciparum malaria and malaria remains a major health problem. The aim of this study was to evaluate the influence of an education program on patients carers' understanding and effective use of anti-malarial drugs for the treatment of uncomplicated malaria in children in general health clinics in PNG. The trial design involved a pre-post intervention study with a control group. The study was undertaken in the National Capital District. Papua New Guinea using one Clinic as the intervention site and another as the control site. The two clinics were similar in characteristics as confirmed in the study by demographic data where there were no significant differences observed. The data collection took placed over the period February to April 2002. It included observation of drug provision at study sites and interviews of patient carers on the first day at the clinic and a follow up seven days later. Three questionnaires were developed to evaluate the process and outcomes of malaria drug treatment in the above health facilities. / Prescribing data were collected from prescriptions and patient carers' interviewed prior to the intervention program. Following the provision of drug information to patient carers. similar drug information and compliance questioning was undertaken. Differences in the pre-post elements of the study and in the control group over the study period were evaluated using Chi-Squared, Kruskal-Wallis, Fisher's Exact or Student's t-tests as appropriate. In excess of 100 patients in the pre- and in the post intervention phases were evaluated for their understanding and effective use of the anti-malarial drugs. In addition, 100 clients were in the control group at another clinic. Patients had attended the clinic up to 8 times in the previous year with a median of 2 visits. Amodiaquine, Fansidar, albendazole and paracetamol made up a total of 60% of the drugs prescribed. The use of medicines was strongly supported with 94.4% indicating no problems with the medication. Only 3% of patients received herbal or local remedies for malaria treatment. 1n patients 10 years or less or their carers, it was found, there was a significant improvement in the carers understanding of the medications. There was a statistically significant improvement in patient outcomes from 57.9% to 92.3% reported as cured following the intervention program. The study has also identified low levels of appropriate administration of antibiotic suspensions in children by patient carers. / For example, incorrect responses recorded for amoxycillin suspension were 80.8% (143). Septrim tablets 92% (23), Septrim suspension 86% (123), erythromycin suspension 100% (26), and chloramphenicol suspension 84.4% (38). In this study the face to face (one-to-one) education program was used to influence patient carers understanding and effective use of drugs. The intervention program involved advising, informing, encouraging, and counselling the patient carers verbally on the appropriate and effective use of medicines. The verbal message was reinforced by a suitable label typed in English and Pidgin-English where instructions were clear, simple and unambiguous. The label was then attached to the envelopes or containers containing the drugs. On feedback, the information on the understanding and effective use of drugs was re-emphasized to the carers to reinforce their understanding for future references. Results showed that the intervention program made an impact in improved patient carers understanding and effective use of drugs and children's health outcomes. In conclusion, it is evident that a patient intervention program designed to improve the dosages and frequency of administration of anti-malarial drugs in PNG had no statistically significant outcome. This may be because the current level of understanding was quite high (>70%) and the study experienced a ceiling effect. However, as shown in the results, the patient carers understanding on the appropriate and effective use of drugs was lower during the pre-intervention and control group. / When compared clinic-pre with clinic-post, there was a significant difference (P < 0.05) in the cured group and the improved cure rate increases from 57.9% to 92.3%. When compared control pre with control post groups, there was no significant difference (P > 0.05) in the cured group. Therefore, the study identified an improvement in patient outcomes with respect to malaria. Hence. the simple intervention program in influencing patient carers understanding of the appropriate and effective use of medications led to a marked improvement in patient outcomes.

The aim of the research was to analyse the organisational dynamics surrounding a health care reform implementation process associated with the introduction of coordinated care, which is an Australian Government initiative to introduce structural changes to the funding and delivery of health-care in response to rising health care costs. A longitudinal case study of an implementation team was studied. This included the perceptions and experiences of individuals and institutions within hospitals, the general practice community and Divisions of General Practice. Furthermore, the case study explored organisational structures, decision-making processes and management systems of the Project and included an examination of the difficulties and conflicts that ensued. The broader context of health care reform was also considered. The study found that an effective change management strategy requires clarity around the definition of primary task in health care delivery, particularly when the task is complex and the environment uncertain. This requires a management and support structure able to accommodate the tensions that exists between providing care and managing cost, in a changing and complex system. The case study indicated that where tensions were not managed the functions of providing care and managing costs became disconnected, undermining the integrity of the task and impacting on the effective facilitation of the change process and hence, the capacity of stakeholders to embrace the model of co-ordinated care. Moreover, the micro dynamics of the project team seemed to parallel the macro dynamics of the broader system where economic and health care provision imperatives clash. Through its close analysis of change dynamics, the study provides suggestions for the improved engagement of stakeholders in health care change.

xv, 270 leaves : photos., tables, graphs ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Agronomy, 1979

Corrigenda inserted behind title page. / Copies of author's previously published articles inserted at end. / Includes bibliographical references (leaves 193-210). / xxii, 210 leaves : ill. (some col.) ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Investigates whether estrogen modulates the proteins associated with calcium transport (eg calcium binding protein, calbindin D28k) in the intestinal tissue during sexual maturation of laying hens. Studies the temporal and spatial expression of estrogen receptors (ER) and calcium binding protein in jejunal tissue. Findings indicated the potential of estrogen to induce calbindin D28K in the intestinal tissue, from which it can be concluded that estrogen may increase calcium absorption and consequently calcium retention. Shows that the amount of estrogen normally present in the reproductive system is sufficient for the normal capacity of egg and eggshell production. Egg production and shell quality are significantly reduced by phytoestrogen. It is recommended that the concentration of phytoestrogen in poultry diets be investigated in more detail as it may act as an anti-nutritive factor and affect metabolism and productivity. / Thesis (Ph.D.)--University of Adelaide, Dept. of Animal Science, 1999

Thesis (Ph.D.)--McMaster University, 2006. / Supervisor: Susan J. Elliott. Includes bibliographical references (leaves 166-171).

<p>Seagrass beds cover large intertidal and subtidal areas in coastal zones around the world and they are subjected to a wide variety of anthropogenic influences, such as nutrient enrichment due to sewage seepage. This study was undertaken to address specific questions focusing on whether near shore tropical seagrasses that receive a constant influx of groundwater nutrient inputs, would exhibit a higher productivity and to what extent epiphytic algae reflect the impacts of nutrient inputs. An additional aspect of study was to determine the prevalence of “acid zones” in tropical seagrasses. The productivity of the seagrasses <i>Cymodocea rotundata</i>,<i> Thalassia hemprichii</i> and <i>Thalassodendron ciliatum</i> was compared in two sites along the Kenyan coast; Nyali (a high nutrient site) and Vipingo (a low nutrient site). Of the three seagrasses <i>T. hemprichii</i> showed the most distinct differences with higher growth and biomass in the nutrient rich site whereas the growth of <i>C. rotundata</i> was similar in the two sites. A high epiphytic cover was found on the shoots of <i>T. ciliatum</i> found in the high nutrient site Nyali.</p><p>Morphological and genetic characterization of bacterial and cyanobacterial epiphytes showed specific associations of nitrogen fixing cyanobacteria on the seagrass <i>C. rotundata</i> in the low nutrient site (Vipingo). At this site, shoots of <i>C. rotundata</i> had a higher C:N ratio compared to shoots in the high nutrient site (Nyali) indicating that the association with nitrogen fixing cyanobacteria is a strategy, for this species, to meet its nutrient needs. Bacterial epiphytes belonging to the group Cytophaga-Flavobacteria-Bacteroides (CFB) were found on <i>T. ciliatum</i> and <i>T. hemprichii</i> from the two sites. CFB bacteria are characteristic of waste water, particularly from livestock farming areas, thereby confirming seepage of groundwater from surrounding catchment areas. These prokaryotic associations were specific for the different seagrasses and it appears that the establishment of epiphytic associations may not be a random encounter but a specific association that meets specific needs.</p><p>The seagrass <i>T. ciliatum</i> in the high nutrient site had an abundance of macroalgal epiphytes and the impact of the epiphytic coverage was assessed using Pulse Amplitude Modulated (PAM) fluorometry. The photosynthetic activity of seagrass parts that were covered by epiphytes was suppressed but the productivity of the whole shoot was not significantly reduced. In the nutrient rich site, epiphytes were found to contribute up to 45% of the total estimated gross productivity, during the SE monsoon season, while epiphytic contribution in the nutrient poor site, was 8%. Epiphytic abundance and contribution to productivity decreased during the NE monsoon. The photosynthetic activity of <i>T. ciliatum</i> shoots was similar in the two study sites with shoots in the nutrient rich site growing faster. <i>T. ciliatum</i>, in the low nutrient site, invested in the development of below ground root tissue which may indicate the development of a strategy to gain access to pore water nutrient pools.</p><p>Carbon uptake strategies of eight tropical seagrasses were re-evaluated to determine how common the “acid zone” mechanism is among tropical seagrasses. Six of the eight species studied showed photosynthetic inorganic carbon (Ci) acquisition based on carbonic anhydrase catalysed HCO₃^- to CO₂ conversions within an acidified diffusion boundary layer (“acid zone”). <i>Cymodocea serrulat</i>a appeared to maintain its carbon uptake by extracellular carbonic anhydrase catalysed CO₂formation from HCO₃^- without the need for acidic zones, whereas, <i>Halophila ovalis</i> appeared to have a system in which H⁺ extrusion may be followed by HCO₃^--H⁺ co-transport into the cells. These findings indicate that competition for carbon, between the host seagrass species and epiphytes, could determine seagrass-epiphyte associations.</p>

<p>This paper presents the feasibility study of setting up the new potting tray production line based on the two alternatives: partly outsource a process in the production line or wholly make all processes in-house. Both the qualitative and quantitative approaches have been exploited to analyze and compare between the make or buy decision. Also the nature of business, particularly SMEs, in Thailand has been presented, in which it has certain characteristics that influence the business doing and decision, especially to the supply chain management. The literature relating to the forecasting techniques, outsourcing decision framework, inventory management, and investment analysis have been reviewed and applied with the empirical findings. As this production line has not yet been in place, monthly sales volumes are forecasted within the five years time frame. Based on the forecasted sales volume, simulations are implemented to distribute the probability and project a certain demand required for each month. The projected demand is used as a baseline to determine required safety stock of materials, inventory cost, time between production runs and resources utilization for each option. Finally, in the quantitative analysis, the five years forecasted sales volume is used as a framework and several decision making-techniques such as break-even analysis, cash flow and decision trees are employed to come up with the results in financial aspects.</p>

<p>AbstractDifferent approaches for implementing a complex multiplier in pipelined FFT are considered andimplemented to find an efficient one in this project. The implemented design is synthesized on Cyclone IIand Stratix III to know the performance. The design is implemented with a focus of reducing the resourcesused. Some approaches resulted in the reduced number of DSP blocks and others resulted in reducednumber of LUTs. Analysis of Synthesis results is performed for different widths (bit lengths) of complexmultiplier approaches.</p>